{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:46:36Z","timestamp":1791229596945,"version":"4.1.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Umbilical venous catheters (UVCs) are essential in neonatal intensive care, yet blind insertion techniques remain common and increase the risk of malposition and liver injury. This study evaluated whether real-time ultrasound guidance improves UVC placement efficiency and safety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analysed 305 neonates who underwent ultrasound-guided UVC placement between July 2023 and January 2025 in a tertiary neonatal unit. The primary outcome was successful tip placement in the subdiaphragmatic vestibule; the secondary outcome was acute catheter-related liver injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Correct catheter placement was achieved in 86.56% of cases, with a gradual improvement from 83.81% to 89.12% over time. Only one hepatic haematoma was observed, and no other acute complications occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Real-time ultrasound guidance significantly enhances the accuracy and safety of UVC insertion in neonates, minimising hepatic injury risk. Further research should assess its role in prolonged catheter monitoring.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1655820","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T09:54:41Z","timestamp":1761040481000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Real-time ultrasound guidance improves neonatal umbilical venous catheter placement efficiency and reduces liver complications"],"prefix":"10.3389","volume":"13","author":[{"given":"Anna","family":"Tomaszkiewicz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Kruczek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Szyma\u0144ski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krystian","family":"Walczak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Teplicki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Sobczak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Mazela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"bcr2015214073","DOI":"10.1136\/bcr-2015-214073","article-title":"Advantages 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study","volume":"122","author":"D\u2019Andrea","year":"2025","journal-title":"Neonatology"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e257","DOI":"10.1097\/PCC.0000000000002919","article-title":"Real-time ultrasound guidance for umbilical venous cannulation in neonates with congenital heart disease","volume":"23","author":"Kozyak","year":"2022","journal-title":"Pediatr Crit Care Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000535096","article-title":"Comparison of ultrasound-guided umbilical venous catheter insertion with blind method: a randomized controlled trial","volume":"9","author":"Mishra","year":"2024","journal-title":"Biomed Hub"},{"key":"B13","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s13052-021-01014-7","article-title":"Real-time ultrasound for tip location of umbilical venous catheter in neonates: a pre\/post intervention study","volume":"47","author":"Rubortone","year":"2021","journal-title":"Ital J Pediatr"},{"key":"B14","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1159\/000451022","article-title":"Umbilical venous catheter malposition is associated with necrotizing enterocolitis in premature infants","volume":"111","author":"Sulemanji","year":"2017","journal-title":"Neonatology"},{"key":"B15","doi-asserted-by":"publisher","first-page":"586","DOI":"10.3348\/jksr.2022.0056","article-title":"Imaging of umbilical venous catheter-related hepatic complications in neonates","volume":"84","author":"Kim","year":"2023","journal-title":"J Korean Soc Radiol"}],"container-title":["Frontiers in 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